Abstract
Background: Zimbabwe has been implementing Index contact tracing and testing (ICT) since 2019 to expedite epidemic control and accelerate the identication of people living with HIV. We identied two comparable provinces (structure, catchment, and location) yet with contrasting HIV prevalence rates to evaluate the program and develop recommendations that can enhance program performance. A process Methodology: evaluation of the ICT program was conducted in 8 randomly selected districts shared between Manicaland and Matabeleland South provinces. A logical framework model was applied to evaluate program inputs and processes, correlated with outputs and contributions toward outcomes. Microsoft Excel 2021 was used to summarize data as frequencies and proportions. W Results: e recruited 1,393 health workers over one year shared between Manicaland, 57.1% (n=795) and Matabeleland South 42.9% (n=598). An overall 80.6% (n=14,500) of the targeted Rapid test kits and 84.9% (n=24,200) of HIVST kits were supplied, resulting in intermittent shortages in both provinces. A copy of the ICT register was supplied per facility against an average of 3 entry points each. Manicaland conducted 33.5% of their targeted ICT trainings against 80% for Matabeleland. Program implementation was scored at 62.2% for Manicaland and 81.8% for Matabeleland South. Manicaland scored an HIVST reactivity rate of 7.7% (871/11,320) whilst Matabeleland South documented a reactivity rate of 6.2% (679/10,890) against a target of 10%. Both provinces scored above 60% of their target for the identication of HIV-positive individuals (Manicaland: 61.1%, Matabeleland South: 79.5%). An overall positivity yield of 62.8% (n=742/1,181) was obtained among index contacts. Index testing proved to be a resourc Conclusion: e-intensive HIV testing model yet highly effective in identifying individuals living with HIV among index contacts. The resource demand is justied by the high positivity yield which can be aided by implementation delity, critical to expediting epidemic control by mopping up clients living with HIV without the knowledge thereof.
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